1. 1
Bed Bugs
Rosmarie Kelly
Public Health Entomologist
GDPH

2. 2
Bed bugs were once a
common public health
pest worldwide.
•Bedbugs were originally brought
to the United States by early
colonists from Europe.
•Bedbugs thrive in places with
high occupancy, such as hotels.
•Bedbugs were believed to be
altogether eradicated 50 years ago
in the United States and
elsewhere with the widespread
use of DDT.

3. 3
They’re Back!
Bed bugs are once again
becoming a problem
within residences of all
kinds, including homes,
apartments, hotels,
cruise ships, dormitories
and shelters.
•The cause of this resurgence is
still uncertain, but most believe it is
related to increased international
travel and the use of new pest-
control methods that do not affect
bedbugs.
•In the last few years, the use of
baits rather than insecticide sprays
is believed to have contributed to
the increase.

4. 4
Of the 90 or so
species in the family
Cimicidae
approximately 7 will
feed on human
blood, but only 2 are
commonly found:
Cimex lectularius
(bed bug) and Cimex
hemipterus (tropical
bed bug).

5. 5
Life Cycle
Female bed bugs deposit 3 to 8 eggs at a
time; a total of 200-500 eggs can be
produced by one female over her 10
month life span.
The eggs hatch in 4-12 days.
Bed bugs go through 5 nymphal stages
before reaching maturity. This usually
takes 35-48 days.

6. 6

7. 7
Habits & Habitats
Bed bugs are active mainly at night; they reach peak activity
before dawn.
During the daytime, they prefer to hide close to where
people sleep.
Their flattened bodies enable them to fit into tiny crevices -
especially those associated with mattresses, box springs,
bed frames, and headboards.
Bed bugs do not have nests like ants or bees, but do tend to
congregate in habitual hiding places.
Bed bugs do not fly, but can move quickly over floors, walls,
ceilings and other surfaces.
Bed bugs will travel 5-20 ft. from an established harborage
to feed on a host. Egg-laying females also wander.

8. 8
Bed Bug Facts
Bed bugs respond to warmth and carbon dioxide when
searching for a blood meal, but not to odors.
All nymphal stages and adults of both sexes require blood
for nutrition and development.
Bed bugs ordinarily feed within 24 hours of hatching, once
between each molt and once before egg deposition; an
average period of 8 days is required between molts.
Adult females will continue to take blood meals every 3-4
days depending on ambient temperature and humidity.
Bed bugs take up to 10 minutes to complete a blood meal,
and will consume 2-5 times their own body weight in blood
during that time.

9. 9
More Bed Bug Facts
Individual bed bugs usually do not feed every night
but at intervals of a few days to a week.
Bed bugs do not remain on the host between
feedings.
Once a bed bug is finished feeding, it quickly
retreats back to its hiding place.
Bed bugs may also feed on small animals, such as
pets.

10. 10
Really Weird Fact
Bed bugs have a unique form
of mating called “traumatic
insemination”.
The male penetrates the
female’s abdomen with his
external genitalia,
inseminating into her body
cavity.
This sexual activity produces a
wound in the female and
probably endangers her
longevity and productivity.

11. 11
Movement
Spending a night (or longer) in an environment which is
already infested by bed bugs (hotels, homes, international
flights, etc).
Having someone visit from such an infested environment
(bed bugs can be transported in luggage).
Renting furniture or buying used furniture or bedding.
Picking up discarded bedding or furniture from a
curbside, trash collection point or dumpster.
Some of the most common ways new
bed bug infestations may be
introduced include:

12. 12
Bed Bug Bites
The bite of a bed bug is painless.
The amount of blood loss due to bed bug feeding typically
does not adversely affect the host.
Bed bugs feed on any bare skin exposed while sleeping
(face, neck, shoulders, arms, hands, etc).
Skin reactions are commonly associated with bed bug
bites, which result from the saliva injected during feeding.
Some individuals do not react to bed bug bites, while
others note a great deal of discomfort often with loss of
sleep from the persistent biting.

13. 13
Reactions to
Bites
Common allergic reactions include the development of
large welts that are accompanied by itching and
inflammation.
The welts usually subside to red spots but can last for
several days.
Blister-like eruptions have been reported in association
with multiple bed bug bites and anaphylaxis may occur in
patients with severe allergies.

14. 14
More on Bites
Depending on bite intensity and frequency, there are typically
five post-bite effect stages: no reaction (no or too few
antibodies developed), delayed reaction, delayed plus
immediate reaction, immediate reaction only, and no visible
reaction (due to excess circulating IgG antibodies).
Typical symptoms include a raised, inflamed, reddish wheal at
each bite site, which may itch intensely for several days.
“Immediate” immune reactions may appear from one to 24 hours
after a given bite and may last 1-2 days.
"Delayed” immune reactions usually first appear one to three (up
to 14) days after a bite and may last 2-5 days.
Humans who are frequently bitten by bed bugs may develop a
sensitivity “syndrome” that can include nervousness, almost
constant agitation (“jumpiness”), and sleeplessness.

15. 15
Bite
Summary
Allergens from bed bugs may be
associated with asthmatic
reactions.
Reactions to the bites may be
delayed up to 14 days before
lesions appear.
Reactions may be accompanied by
severe itching that lasts for
several hours to days.
Scratching may cause the welts to
become infected.
Bed bugs have never been proven
to biologically transmit any
human pathogen.

16. When you stay at a hotelWhen you stay at a hotel
DO NOT BRING ANYTHING INTO
THE ROOM UNTIL YOU DO AN
INSPECTION
Bed bugs prefer wood, fabric, and paper surfaces:
•Check bed first: mattress seams, under labels, buttons, corner protectors
•Behind headboard
•Hanging pictures
•Bedside furniture
•Loose wallpaper
•Baseboards
•Curtains

17. 17
INSPECTION
If the inspection site is a hotel, it is important that the
housekeeping staff be interviewed.
Efforts should be concentrated on dark, isolated and protected
areas. Bed bugs prefer wood, paper and fabric surfaces and so
these materials should receive special attention during the
inspection process.
The mattress should be the first site inspected and the seams,
beading, under buttons, labels, and corner protectors (if not
previously removed) should be examined closely.
If headboards are attached to the wall, they should be
removed. Removing headboards from the wall is important, as
this may be the first place bed bugs will be found when the
infestation is light.

18. 18
Where to Look - Most Everywhere
It can take 1-2 hours to thoroughly check a space for bed bugs. Be thorough!

19. 19
Check the Bed
Remove all the sheet, checking for blood spots.
Stand the mattress up. Remove the box spring and flip it over.
1.Inspect the mattress closely, paying close attention to the
seams.
2.Inspect inside the box spring and under it (where it meets the
bed frame). Shine a flashlight through the bottom of the box
spring.
3.Check any head and foot boards as well as anything stored under
the bed.

20. 20

21. 21
Check the
Rest of the
Room
Check inside all drawers, crevices, and narrow spaces.
Look under electronics, behind pictures, and in stacks of
clothing.
Bed bugs are often found hiding in tack strips under wall-
to-wall carpeting and behind baseboards.
Bed bugs tend to crawl up, so check check drapes and wall
decorations.

22. 22
Check All
Furniture
Remove sofa cushion, and check all seams and crevices.
Tip back couches and chairs and look underneath,
particularly behind skirts.

23. 23
In any infestation, the adjoining rooms,
both sides, and above and below, should
be inspected.
Common rooms, such as a lounge, should
not be overlooked.

24. 24
“New” Technology
bed bug sniffing dog
Ability of Bed Bug-Detecting Canines to Locate Live Bed Bugs and Viable Bed Bug Eggs
MARGIE PFIESTER, PHILIP G. KOEHLER, AND ROBERTO M. PEREIRA
J. Econ. Entomol. 101(4): 1389-1396 (2008)
http://sleeptightllc.biz/184846.pdf

25. Responses You Will Get
25
HOTEL Manager/Owner
•
It’s just bed bugs, big deal (in
some areas of the world bed
bugs are so numerous that
babies become anemic from
being fed on)
•
That isn’t a bed bug!
•
You brought that in here!
•
I will call my pest control
company right now.
Hotel Customer
•
Get it off! Get it off! Get it off!
•
I’m suing!
•
ARRRRGGGGHHHHHHH!

26. 26
Taking Precautions
Don’t bring bed bugs home with you.
•Place service kit and equipment in an open area away from walls and
furniture
•Assume beds, furniture, and other items you are about to inspect or treat
are infested and act accordingly.
•Avoid laying across, leaning against, or sitting on potentially infested
beds or furniture and minimize direct contact with any potentially
infested materials such as drapes, rugs, piles of dirty clothes.
•Bring a minimum of equipment into the room. If you carry an inspection
kit or service kit, place it in an open area away from walls and furniture.

27. 27
DO NOT DO THIS

28. 28
More
Precautions
■ Remove your clothes over a non-carpeted floor and be ready to
immediately capture and destroy any bug you see.
■ If you are concerned that your clothes might contain bed bugs, launder
them in hot water as soon as possible. Take off your clothes as soon as
you get home.
■ If you have been in a severely infested building or feel that you may
have interacted with bed bugs, you may want to change and bag your
clothes before leaving the site and have the clothes in question
laundered (this assumes that you have an extra set of clothes
available).

29. 29
Know What You Are Looking For
female male

30. 30
nymph

31. 31
Not Bed Bugs
http://ipm.ncsu.edu/AG369/keys.html
Key to Common Pests of Man and Animals

32. 32

33. 33
Swallow Bug

34. 34

35. 35
Treatment & Control -
Phase One
If bed bugs are found, the hotel management needs to
consult a licensed pest control professional.
A written integrated pest management (IPM) plan should
be requested from the pest control operator. This plan
should detail the methods and insecticides to be used by
the pest control operator and describe the efforts
expected by the building manager.
Generally, pesticides will need to be applied in conjunction
with any non-chemical means of control; non-chemical
options should be considered as management tools only.

36. 36
Treatment & Control
- Phase Two
Good housekeeping practices and a reduction in possible
harborages such as clutter, cracks, and crevices will
discourage repeat infestations.
As bed bugs are good at concealing their location,
complete control is often difficult to achieve with the first
treatment. This is especially so heavy infestations and thus
a post control treatment evaluation is always advisable.

37. 37
Physical Removal
Where infestations are heavy, treatment and removal of
infested furniture and mattresses may be necessary.
If bed bug numbers are small, they can be physically
removed from mattresses and harborage sites by
vacuuming.
After bed bugs are removed, cracks in plaster need to be
repaired and loosened wallpaper glued down to eliminate
bed bug harborage sites.
Bed bug exclusion covers can be used on mattresses and
bed springs to prevent re-infestation.

38. 38
Temperature Extremes -
Steam Heat
Bed bugs are very sensitive to heat, and a combination of
steam cleaning and insecticide use has been found to be
more effective for long-term control than insecticides
alone.
The steam emission tip must usually be about 2.5-3.8 cm
from the surface being steamed.
If the tip is too far away, the steam may not be hot enough
to kill all the bed bugs and eggs that it contacts.
If the tip is too close, excess moisture may be injected into
the treated material, which may lead to other problems

39. 39
Temperature Extremes -
“Dry” Heat
For heat treatment to be effective, it is critical that high
temperature and low relative humidity be attained for a
minimum length of time (49-52o
C [120-125o
F] and 20-30%
relative humidity for 20-30 minutes).
Heat treatment provides no residual effect, and bed bugs
can re-occupy any site so treated immediately after
temperatures return to suitable levels.
Laundering infested linens or cloth items in hot water with
detergent, followed by at least 20 minutes in a clothes
dryer on high heat, should kill all life stages of bed bugs
but would not prevent their reinfestation.

40. 40
Temperature Extremes - Cold
Exposure to low temperatures can kill bed bugs if they are
kept cold enough long enough.
Bed bugs can tolerate -15o
C (5o
F) for short periods and, if
acclimated, they can survive at or below 0o
C (32o
F)
continuously for several days.
Freezing furniture or other items within containers or
chambers [e.g., below 0o
F (-19o
C) for at least four days]
may be a practical alternative for limited infestations or to
augment other control measures.
A new commercial technology uses CO2 from cylinders
deposited as a “snow” to kill bed bugs and a variety of
pests by rapid freezing.

41. 41
Pesticides - THE LABEL IS THE LAW
Currently, non-chemical products and techniques are incapable of
efficiently or quickly controlling or eliminating established bed bug
populations.
Precise placement of a suitably labeled, registered and formulated
chemical insecticide is still the most practically effective bed bug
control.
The choice of chemical products and specific application
techniques can depend on many factors, including the physical
location and structural details of the bugs’ harborages, the
product’s labels (which can vary by political jurisdiction), the
immediate environment, and local or national laws.

42. 42
• Residual Applications
• Crack-and-Crevice Applications
• Dusts
• IGRs
• Fumigation
• ULVs, Aerosols, & Foggers

43. 43
FOLLOW-UP
To avoid spreading the bed bugs, the room or rooms
should not be used until they have been found to be
bug-free.
The local Environmental Health Specialist should
recheck the room(s) after they have been treated and
re-evaluated by the licensed pest control professional to
ensure that steps were taken to eliminate and prevent
the bug infestation.
Glue boards placed close by harborage areas may help
monitor bed bug activity by catching bed bugs as they
move about at night.

44. 44
More FOLLOW-UP
Many times the first application does not seem to give
complete or immediate control. Additional treatments may
be necessary in 7 to 14 days.
At least one follow-up inspection of infested sites should
be conducted at a suitable interval (e.g., 1 week) after
each control effort or treatment in order to detect any of
the typical signs of continued infestation, such as live
bugs, cast skins (after those present earlier had been
removed), fecal spots on bed linens or harborages, and
unhatched eggs.

45. 45
A Few Useful References
http://www.ces.ncsu.edu/depts/ent/notes/Urban/
bedbugs.htm
http://www.afpmb.org/pubs/tims/TG44/TG44.htm
http://www.techletter.com/bedbugalert.html
http://health.state.ga.us/epi/zvbd/infest/index.a
sp

46. 46
Recap
Hotel responsibility
Follow up on all complaints
Work with environmental health and a licensed pest
control company
Follow clean up recommendations precisely
Do not use infested rooms until given an “all-clear”
Environmental Health responsibility
Follow up on complaints
Know what a bed bug looks like
Communicate with hotel and pest control
Re-inspect

47. State Entomologist’s Responsibility
•
Training/education
•
Support
•
Mapping
47

48. 48
Any Questions?
Good Night.
Sleep Tight.
Don’t let the bed bugs bite.